ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Occlusal Changes from Obstructive Sleep Apnea Appliances Are Not Self-Limiting and Continue to Progress
Clinical Question In patients who use an obstructive sleep apnea appliance, are the occlusal changes that occur progressive and/or self-limiting?
Clinical Bottom Line Occlusal changes due to long-term use of an oral appliance to treat obstructive sleep apnea are not self-limiting and continue to progress.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25325593Pliska/201477 adult patients with obstructive sleep apnea (OSA) treated with mandibular advancement splints (MAS). Cohort Study
Key resultsAfter the study time period of an average 11 years, the authors reported a significant reduction (p < 0.001) of “overbite (2.3 ± 1.6 mm), overjet (1.9 ± 1.9 mm), and mandibular crowding (1.3 ± 1.8 mm). A corresponding significant (p < 0.001) increase of mandibular intercanine (0.7 ± 1.5 mm) and intermolar (1.1 ± 1.4 mm) width as well as incidence of anterior crossbite and posterior open bite were observed.”
Evidence Search ("sleep apnea"[All Fields] OR "sleep apnea syndromes"[MeSH Terms] OR ("sleep"[All Fields] AND "apnea"[All Fields] AND "syndromes"[All Fields]) OR "sleep apnea syndromes"[All Fields] OR ("sleep"[All Fields] AND "apnea"[All Fields]) OR "sleep apnea"[All Fields]) AND ("therapy"[Subheading] OR "therapy"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields]) AND occlusal[All Fields] AND ("Changes"[Journal] OR "changes"[All Fields]) AND ("splints"[MeSH Terms] OR "splints"[All Fields] OR "splint"[All Fields])
Comments on
The Evidence
Validity: The presented article is a cohort study that followed the subjects for an average of 11 years and had a greater than 80% completion rate. There were no conflicts of interest. Perspective: This study is important to dentists treating sleep apnea, because it is the longest longitudinal study to date on the progression of changes in occlusion due to the use of obstructive sleep apnea appliances.
Applicability For patients with OSA, oral mandibular advancement appliances are one of the therapeutic options. The occurrence and progression of occlusal changes caused by these devices should be considered, and patients should be informed about this risk.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords Obstructive sleep apnea, obstructive sleep apnea appliances, occlusal changes, splint
ID# 2857
Date of submission: 03/30/2015spacer
E-mail velae2@livemail.uthscsa.edu
Author Eduardo Vela
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail wrighte2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
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